Health economic modelling in nuclear medicine: setting innovation priorities or boundaries? For the nuclear medicine and molecular imaging community

This thesis positions PET/CT as an instrumental procedure whose value derives from changing patient management decisions in ways that improve patient outcomes under healthcare budget and resource constraints. It introduces opportunity costs and Dutch willingness-to-pay thresholds (€20k/€50k/€80k per QALY), illustrates why clinical evidence must extend beyond diagnostic accuracy outcomes, and outlines health economic modelling techniques (decision trees, Markov processes and discrete event simulation) and uncertainties (heterogeneity, stochastic, structural and parameter uncertainty) that recur throughout this thesis. The main aim is to show how and when the clinical application of PET/CT adds value for money to patients. Therewith, this thesis intends to provide the nuclear medicine and molecular imaging community with an improved understanding of health economic modelling, and to assess the cost-effectiveness of PET/CT for specific (selected) patient populations and care pathways.